Aminoglycosides
PREGNANCY CATEGORY D
Therapeutic Actions
Aminoglycosides are antibiotics that are bactericidal. They inhibit protein synthesis in susceptible strains of gram-negative bacteria and appear to disrupt the functional integrity of bacterial cell membrane, causing cell death. Oral aminoglycosides are very poorly absorbed and are used for the suppression of GI bacterial flora.
Indications
Short-term treatment of serious infections caused by susceptible strains of Pseudomonas species, Escherichia coli, indole-positive Proteus species, Providencia species, Klebsiella-Enterobacter-Serratia species, Acinetobacter species
Suspected gram-negative infections before results of susceptibility studies are known
Initial treatment of staphylococcal infections when penicillin is contraindicated or when infection may be caused by mixed organisms
Neonatal sepsis when other antibiotics cannot be used (used in combination with penicillin-type drug)
Unlabeled uses: As part of a multidrug regimen for treatment of Mycobacterium avium complex (a common infection in AIDS patients) and orally for the treatment of intestinal amebiasis; adjunctive treatment of hepatic coma; for suppression of intestinal bacteria for surgery; and for the treatment of Mycobacterium tuberculosis
Contraindications and Cautions
Contraindicated with allergy to any aminoglycosides, renal disease, hepatic disease, preexisting hearing loss, myasthenia gravis, parkinsonism, infant botulism, lactation.
Use cautiously in elderly patients; patients with diminished hearing; patients with decreased renal function, dehydration, neuromuscular disorders, pregnancy.
Adverse Effects
CNS: Ototoxicity, confusion, disorientation, depression, lethargy, nystagmus, visual disturbances, headache, fever, numbness, tingling, tremor, paresthesia, muscle twitching, seizures, muscular weakness, neuromuscular blockade, apnea
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